Patient Yang XX, male, 27 years old, from Laizhou, Yantai, had a history of multiple previous pneumothorax attacks. The patient presented with simultaneous bilateral pneumothorax attacks before January 2015, and came to our hospital for minimally invasive surgical treatment after the onset of the attack to the local municipal people’s hospital with poor results. In order to minimize the surgical injury, after adequate preoperative preparation and surgical design, the patient underwent simultaneous bilateral pneumonectomy with single-port thoracoscopy via the subxiphoid process. The operation was performed by making only a less than 3-cm-long incision under the patient’s subxiphoid process, entering the bilateral thoracic cavities subconsciously through the anterior mediastinum, observing and treating both lobes simultaneously, and completing the resection of bilateral alveoli without turning over midway. The operation went very smoothly, and the patient was able to get out of bed on the same day after waking up from anesthesia, and recovered satisfactorily after the operation, and was discharged from the hospital three days after the operation. Traditional thoracoscopic surgery requires one to three observation and operation holes in the chest wall, and even though unilateral lobectomy and radical lung cancer resection can be accomplished through a single hole, the intrusion of the intercostal nerve by the intraoperative operation of the chest incision and the compression of the postoperative drainage tube are still important causes of postoperative chest pain or chest wall numbness. For patients with bilateral lesions, bilateral chest wall perforations and the need for intraoperative turning add to the trauma, prolong the operation and anesthesia time, and increase postoperative pain. To solve the above problems, Director Hu Dehong, based on his rich theoretical and skilled thoracoscopic techniques, boldly innovated according to the special anatomical structure of the subxiphoid tissue in the upper abdomen, and completed bilateral alveolar resection and pleural fixation through a small hole of about 3 cm under the subxiphoid process in the upper abdomen, making both a lumpectomy observation hole and an operation hole at the same time, and the operation was completed within 1.5 hours. The patient had mild postoperative pain and could get out of bed early; avoided coughing weakness due to chest pain, could promote early lung expansion and rapid recovery, and shortened drainage tube retention time and postoperative hospital stay. Thoracoscopic surgery has become the most common and mature type of surgery for minimally invasive treatment of thoracic surgical diseases in recent years. Its good efficacy and minimally invasive superiority have been widely confirmed, and it is recognized as the first choice of surgery for common surgical diseases of the chest. It is the common expectation of thoracic surgeons and patients to achieve good surgical results with the smallest and least incision and surgical trauma under the premise of ensuring successful thoracic surgery and exact efficacy, and it is also the goal of thoracic surgeons to explore all the time. The single-port subxiphoid thoracoscopic technique is a bold innovation that achieves fewer incisions and less trauma. This procedure is especially suitable for patients suffering from bilateral lung diseases at the same time because the surgical incision is under the subxiphoid process and there is no bony structure around it, which avoids damage and injury to intercostal nerves, smaller incisions and trauma, faster recovery, and postoperative wound pain and skin numbness can be significantly improved. While reducing post-operative pain, the scars are more easily concealed, making it ideal for young patients who require a higher degree of aesthetics. At the same time, because patients have less post-operative pain, fewer complications and faster recovery, the hospital stay is shortened, resulting in faster bed turnover and enabling the effective achievement of maximum utilization of medical resources.